Emergency devices

ABSTRACT

Described herein are syringe devices comprising a syringe including a therapeutic dose of at least one drug to be used in a drug or substance overdose.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. Ser. No. 16/422,639, filedMay 24, 2019, which claims the benefit of U.S. provisional patentapplication No. 62/676,742, filed May 25, 2018, the entire disclosureseach of which are incorporated herein by reference.

FIELD

The present invention relates generally to syringes, encasements forsyringes, devices including syringes, and methods of using same foremergencies.

SUMMARY

Described herein generally are syringe devices that can deliver atherapeutic dose of a pharmaceutical agent used to treat a drug orsubstance overdose. In some embodiments, the therapeutic dose can beless than the amount of pharmaceutical agent in the syringe. The devicescan also prevent device tampering by a user and/or multiple uses of thesame syringe device. In some embodiments, the syringe devices describedherein can be used in a critical situation for delivery of an emergencyand/or time sensitive pharmaceutical agent in response to a drug orsubstance overdose. The syringe devices can include a syringe thatincludes a dose of at least one pharmaceutical agent and can deliver atherapeutic dose of the pharmaceutical agent that can be less than theamount of pharmaceutical agent in the syringe. The syringe can alsoinclude a stopper and a gas bubble between the at least onepharmaceutical agent and the stopper. In other embodiments, a gas bubbleis not needed and/or desired.

The syringe devices can include an encasement to house the syringe andplunger assembly including a plunger rod, an actuator, and a spacer. Insome embodiments, when assembled, the syringe devices can prevent usersfrom tampering with the encased syringe and/or using it for more thanone pharmaceutical agent delivery. In some embodiments, the syringedevices can be single use and lock after use.

In various embodiments, the actuator and the spacer can be configured tobe secured around the plunger rod. The actuator can include channels andthe plunger rod can include protrusions, and the protrusions can beconfigured to fit within the channels and can provide an adjustableplunger rod location without moving a force application surface.

In some embodiments, the actuator itself can include a finger depressionlocation at the syringe device's force application location instead offorce being applied to the plunger rod as in conventional syringes.

The plunger assembly, in some embodiments, can be configured to move thestopper a predetermined distance without a user touching the plunger rodor being able to retract the plunger rod.

In some embodiments, the encasement can be a rigid plastic casing andcan include a window configured to allow a user to view the at least onepharmaceutical agent in the syringe to determine if the at least onepharmaceutical agent has or has not expired. A user can tell frompotential cloudiness or discoloration if the at least one pharmaceuticalagent has expired.

In other embodiments, the encasement can include a needle guardconfigured to allow the user to cover the needle after use. In suchembodiments, the needle guard can slide down from the encasement overthe exposed needle to protect from accidental needle sticks after use.

The at least one pharmaceutical agent can be any pharmaceutical agent orcombination of pharmaceutical agents described herein. In someembodiments, the pharmaceutical agent(s) can be ones that might be usedin an emergency situation to treat a drug or substance overdose. Suchpharmaceutical agents can include, but are not limited to naloxone. Insome embodiments, a therapeutic amount of these pharmaceutical agentscan be about 1 mg to about 100 mg.

Embodiments include syringe devices including a syringe comprising avolume of at least one pharmaceutical agent and a stopper; a plungerassembly including a plunger rod, an actuator, and a spacer. Thesesyringe devices' plunger assemblies can be configured to providesubstantially identical doses of the at least one pharmaceutical agenteven if more or less pharmaceutical agent is provided in the syringe bymoving the stopper a predetermined distance. The volume of thepharmaceutical agent in the syringe can be at least about 0.5 cc.

Also described herein are methods for using the herein-described syringedevices to deliver a pharmaceutical agent(s). Some methods can be foradministering a therapeutic dose of at least one pharmaceutical agent.In some embodiments, the administering can be in an emergency to treat adrug or substance overdose. The methods can include advancing a stopperthrough a syringe including the therapeutic dose of the at least onepharmaceutical agent thereby delivering it to a patient in need thereof.

This advancing can be a predetermined distance. In various embodiments,advancing the stopper the predetermined distance allows a particularamount of pharmaceutical agent to be extruded and/or ejected from thesyringe device, for example, through a needle. In some embodiments, theadvancing can be configured to deliver about 1 mg to about 100 mg of theat least one pharmaceutical agent to a user and/or patient. Otheramounts of pharmaceutical agent can be delivered in other embodiments.

In some embodiments, the actuator and the spacer may be configured to besecured around the plunger rod and provide the predetermined distancebetween a start point and an end point on the spacer.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a perspective view of a syringe device as describedherein.

FIG. 2 is an exploded view of the syringe device of FIG. 1 .

FIG. 3A illustrates a cross-sectional view of the syringe of FIG. 1 witha pharmaceutical agent in the syringe. FIG. 3B illustrates anothercross-sectional view of the syringe of FIG. 1 .

FIG. 4 illustrates a non-limiting assembly method for the syringedevices as described herein.

FIG. 5A illustrates a side view of a case for the syringe devicesdescribed herein in an open configuration. FIG. 5B illustrates a topview of a case for the syringe devices described herein in an openconfiguration without a syringe device. FIG. 5C illustrates a top viewof a case for the syringe devices described herein in an openconfiguration including a syringe device loaded therein.

FIG. 6 illustrates a case of FIGS. 5A-C in a closed configuration.

FIG. 7 illustrates two cases coupled together to form a single unit.

FIG. 8 illustrates a non-limiting method of using the herein describedsyringe devices.

DETAILED DESCRIPTION

Described herein generally are syringe devices that allow accuratedosing of a pharmaceutical agent(s), even in situations that requireimmediate and sometimes rushed interventions in response to a drug orsubstance overdose. In some embodiments, these situations can beemergency situations where a drug or substance overdose has occurred andtime is of the essence.

The syringe devices and/or any accompanying packaging or casing can besized to be small enough to be portable and/or easily stored. In someembodiments, small size can allow end users to more easily carry thesyringe devices and have them available in an emergency situation. Insome embodiments, the syringe devices can be stocked in emergency roomsand with emergency medical personnel. Other first responders can also besupplied with syringe devices as described herein. Emergency medicalkits can include a syringe device or a syringe device can be deployedwhen responding to a situation with a drug or substance overdose.

In some embodiments, syringe devices can be supplied at locations wheredrug and/or substance abuse is likely to occur. For example, syringedevices can be supplied at concerts, parties, clinics, homelessshelters, halfway houses, sober living facilities, and the like.

The syringe devices described herein can allow for current manufacturingtolerances without affecting delivered volume accuracy as will bedescribed herein. A controlled tolerance loop can be used for a deliverystroke in combination with an adjustable plunger rod at the point ofsecondary packaging. In other words, in some embodiments, volumedelivery accuracy does not change if more or less pharmaceutical agentis delivered in a syringe prior to assembly of the syringe device.

Further, features of the syringe devices can prevent outward movement ofa plunger rod/stopper under all conditions by means of a mechanicalstop. A mechanical stop can prevent outward movement that can introduceair into a needle and/or a syringe that can prevent introduction of apharmaceutical agent during an emergency drug or substance overdose. Thesyringe devices can also include a removable locking mechanism. Thelocking mechanism can be removed prior to use. This removable lockingmechanism can prevent inward movement of the plunger rod/stopper up tothe point of use.

The syringe devices can also provide tactile feedback to a user at theend of a stroke. This tactile feedback can be useful to inform the userthat a dose has been delivered.

Further, the syringe devices can include a locking feature that locksthe plunger rod down at the stroke end to assure gas bubbledecompression and accurate delivered volume. In some embodiments, a gasbubble is not included and no gas bubble compression exists at the endof a plunger stroke.

The syringe devices can encase a pharmaceutical agent filled syringesuch that an end user cannot unscrew or over screw the plunger rod fromthe stopper and change the travel stroke and thus delivered volume. Insome embodiments, a user would have to physically break open the syringedevice in order to alter pharmaceutical agent delivery.

A syringe device can be as illustrated in FIG. 1 . FIG. 2 illustrates across-section thereof and FIGS. 3A-C illustrate various cross-sectionsthereof. Syringe device 100 can include a needle 102, a needle guard104, an encasement 106, and a plunger assembly 108. Encasement 106 andplunger assembly 108 can include many features that will be described inmore detail herein.

Encasement 106 can include one or more labels that provide informationabout the pharmaceutical agent(s) being delivered via syringe device100. As illustrated in FIG. 1 , label 110 can cover substantially anentire surface of encasement 106. However, in other embodiments, label110 may not cover an entire surface of encasement 106 or multiple labelscan be used instead of one large label. In fact, in some embodiments,any number of labels of any shapes can be used to label the product asneeded.

Encasement 106 can include any number of flanges. Upper flanges canprovide counter balance locations to apply force during injection.Encasement 106 includes a first upper flange 112 on first side 114 andsecond upper flange 116 on second side 118. Encasement 106 can, in otherembodiments, include an upper flange that wraps around the entireperimeter or a substantial portion of the perimeter of encasement 106.However, in the embodiment illustrated in FIG. 1 , first upper flange112 and second upper flange 116 are not on the entire perimeter of topsurface 120 of encasement 106 in order to reduce the size of syringedevice 100.

Encasement 106 can also include a first lower flange 124 on first side114 and second lower flange 126 on second side 118. Again, encasement106 can, in other embodiments, include a lower flange that wraps aroundthe entire perimeter or a substantial portion of perimeter of encasement106. However, in the embodiment illustrated in FIG. 1 , first lowerflange 124 and second lower flange 126 are not on the entire perimeterof bottom surface 122 of encasement 106 in order to reduce the size ofsyringe device 100,

In one embodiment, first lower flange 124 and second lower flange 126create a bottom surface 128. Bottom surface 128, first lower flange 124,and second lower flange 126 can aid with needle insertion by providing apush point. Further, bottom surface 128 with a large surface areaprovided by the flanges can promote correct orientation with respect tothe skin for maximum needle penetration depth.

One or more areas or portions on the face of encasement 106 can includegripping surfaces. Gripping surfaces can include those with textures,perforations, holes, or any other structures that promote grip ofsyringe device 100. In one embodiment, a gripping surface can behorizontal lines of raised surface. In some embodiments, a grippingsurface can be molded into an encasement, and in other embodiments, agripping surface can be coated in a surface with a high degree offriction, such as rubber. Gripping surfaces or gripping areas canpromote easy grasping of syringe device 100 and promote many differentsyringe holding styles. In one embodiment, a first grip area 130 canexist between first upper flange 112 and first lower flange 124 and asecond grip area 132 can exist between second upper flange 116 andsecond lower flange 126.

Encasement 106 can also include one or more indicia of pharmaceuticalagent effectiveness. Indicia can include temperature color change labelsthat indicate whether the syringe has been subjected to suboptimaltemperatures, one or more windows that allow a user to view thepharmaceutical agent within a syringe located within encasement 106,and/or a seal that can be broken prior to use to alert a user whetherthe syringe had previously been tampered with. In some embodiments,encasement 106 has one or more windows through first side 114, secondside 118, or both. In one embodiment, encasement 106 includes a firstwindow 134 on first side 114 and a second window 136 on second side 118.First window 134 and second window 136 can allow a user to view thepharmaceutical agent housed within encasement 106 to see, for example,if a clear solution may be cloudy and hence expired.

An exploded view of syringe device 100 is illustrated in FIG. 2 . Withinencasement 106 resides several of the syringe device's components.Loaded from distal end 202 of encasement 106 is a syringe stop ring 204that allows a spring 206 to rest within. Syringe stop ring 204 includesa hole 208 through its body through which a needle 102 and syringe bodyis inserted through. Spring 206 can rest between syringe stop ring 204and flange 210 of syringe 212. This arrangement is illustrated incross-sectional FIGS. 3A and 3B. In some embodiments, syringe flange 210can be held against spacer 220 by spring 206. If during force ofactuation, there is a separation between spacer 220 and syringe flange210, spring 206 can close this separation after user applied force isremoved.

Syringe 212 can include an internal volume 214 that can be filled withone or more pharmaceutical agents. Pharmaceutical agents can be extrudedand/or ejected from needle 102 by applying force to stopper 216 byplunger rod 218. Plunger rod 218 can come bonded to stopper 216 or canbe screwed into or otherwise attached to stopper using any means knownin the art.

Plunger rod 218 is part of plunger assembly 108. Plunger assembly 108includes plunger rod 218, spacer 220, actuator 222, and top 224. Plungerrod 218 can include multiple protrusions 226 that can interact withchannels 228 within inner surface of actuator 222. Protrusions 226 canlock actuator 222 to plunger rod 218.

Spacer 220 is used as a top stop 230 and a bottom stop 232 for actuatorring 234. Top and bottom stops control the amount of stopper travelthrough syringe 212 and hence the precise amount of pharmaceutical agentextruded and/or ejected from needle 102. Distance 236 can be definedbetween top stop 230 and bottom stop 232. Distance 236 can be about 4mm, about 5 mm, about 6 mm, about 7 mm, about 8 mm, about 9 mm, about 10mm, about 12 mm, about 14 mm, about 16 mm, about 18 mm, about 20 mm,about 22 mm, about 24 mm, between about 1 mm and about 24 mm, betweenabout 4 mm and about 14 mm, or between about 10 mm and about 24 mm.

Distance 236 includes travel distance through spacer cavity 238 anddistance through spacer cavity bore 240. Spacer cavity bore 240 includesa partial internal diameter that fits the outer partial diameter ofactuator ring 234. In some embodiments, spacer cavity 238 includes aninternal diameter that is larger than the outer partial diameter ofactuator ring 234. Thus, in some embodiments, when actuator ring 234 isadvanced out of spacer cavity bore 240 into spacer cavity 238, itencounters an area where actuator ring 234 is not guided by the fit inspacer cavity bore 240. In order to account for the travel throughspacer cavity 238, actuator 222 includes at least one guide rail toprevent rotation(s) and/or alignment issues when advancing actuator 222.In one embodiment, actuator 222 includes first guide rail 242 and secondguide rail 244. First guide rail 242 and second guide rail 244 travelagainst front face 246 of spacer 220.

In some embodiments, distance 236 can be changed, for example reduced,by increasing the thickness of actuator ring 234. Likewise, distance 236can be increased by reducing the thickness of actuator ring 236. Byincreasing the thickness of an actuator ring, the amount of distancetraveled between top stop 230 and bottom stop 232 can be reducedresulting in less volume of pharmaceutical agent being extruded and/orejected from needle 102. Such reduced travel distances can be used withsmaller patients that require less pharmaceutical agent to treat aparticular symptom of drug or substance overdose. For example, in someembodiments, in an emergency drug or substance overdose situation, thepatient may have a thin or lightweight build from years of abuse.

In some embodiments, distance 236 can be changed by decreasing thedistance between top stop 230 and bottom stop 232 without changing thethickness of actuator ring 234. By adjusting, e.g., increasing ordecreasing, the distance between top stop 230 and bottom stop 232, theamount of distance traveled between top stop 230 and bottom stop 232 canbe changed resulting in more or less volume of pharmaceutical agentbeing extruded from needle 102.

In embodiments, distance 236 can be changed by combinations of adjustingthe thickness of actuator ring 234 and adjusting the distance betweentop stop 230 and bottom stop 232.

Actuator 222 can be adjusted relative to plunger rod 218 based onfilling variability. FIGS. 3A and 3B illustrate this. In other words,regardless of the volume of pharmaceutical agent in a particular syringe(and hence a location of stopper 216 relative to flange 210), actuator222 and stopper 220 can be attached to plunger rod 218 and provide anaccurate pharmaceutical agent volume delivery.

In one embodiment, if a syringe is provided with too much pharmaceuticalagent volume, the actuator and the spacer can be attached around theplunger rod such that protrusions 226 are at a higher location inchannels 228. In such an embodiment, the ultimate delivered volume wouldbe the same as if the syringe was provided with less pharmaceuticalagent volume.

This changeability of plunger assembly can allow variability in fillvolume without having to change manufacturing processes to accommodatedifferent and/or inaccurate fills. The changeability allows for aparticular volume of pharmaceutical agent to be extruded and/or ejectedfrom needle 102 regardless of the actual fill volume in the syringe.

In some embodiments, a snap 248 is located at bottom stop 232 to lockplunger rod 218 down via actuator ring 234 at the end of an injectionstroke. This lock prevents attempted multiple uses of a syringe. Inessence, the lock allows a syringe to be a single use, disposablesyringe.

Top 224 includes a hole through it to allow the assembled plunger rod218, spacer 220 and actuator 222 to protrude at least partially. Top 224includes at least one tooth, such as first tooth 250 and second tooth252 to snap into portions of encasement 106. After top 224 is lockedinto encasement 106, it acts to lock spacer 220 into place by wedgingspacer 220 between top 224 and syringe flange 210.

In some embodiments, spacer 220, actuator 222, and top 224 can be keyedto encasement 106 to prevent rotation of the components once assembled.

In some embodiments, syringe device 100 can include a needle guard 254.Needle guard 254 can be manually deployed. Needle guard 254 can includeat least one hole 256 that can align with a window on encasement 106when the needle guard has not been manually deployed. Needle guard 254can be deployed to aid in injury prevention after use of syringe device100.

Needle guard 254 can be manually deployed by applying pressure to andpulling on one or more tabs 258 away from proximal end 260 of encasement106. Proximal end 260 includes indentations 262 to allow full retractionof needle guard 254 into encasement 106. Once fully deployed, needleguard 254 can lock into place preventing needle 102 from being usedfurther or accidentally lancing a human handling the used syringe. Thismay be particularly important when treating a drug abuser that may haveillness or disease acquired from the drug abuse, such as but not limitedto HIV and AIDS.

In some embodiments, the needle guard can automatically retract after adose of pharmaceutical agent has been delivered to a patient. As theuser retracts the needle from the patient, needle guard 254 deploys fromencasement 106. Deployment can be through a spring force unlocked whenforce is placed on proximal end 260 of encasement 106 during aninjection. Thus, when pulling device 100 away from a patient's skin,needle guard 234 can deploy. In other embodiments, a button can bepressed to begin deploying needle guard 254. The button can simplyrelease a spring force that snaps needle guard into place preventing anaccidental needle stick.

Actuator 222 can further include a force application surface 262 at itsdistal end. Force application surface 262 can be a concave surface 264promoting user comfort during actuation of the syringe devices. Further,in some embodiments, force application surface 262 can be textured toaid in user feeling when using the syringe devices.

In some embodiments, force application surface 262 can be transparent,such as including a window 272 provided by a material allowing a user tosee the top of plunger rod 218. Window 272 can be through the entiretyof force application surface 262, particularly at apex of concavesurface 264 or otherwise in the center thereof.

The top of plunger rod 218 can include an indication surface 266.Indication surface 266 can be unique to the pharmaceutical agentincluded in device 100. In some embodiments, indication surface 266 caninclude raised features such as shapes or can include words or imagesapplied to the surface.

This windowed configuration can prevent label tampering, because theindication surface 266 is internal to the device.

As further illustrated in FIGS. 3A and 3B, internal volume 214 includesa liquid pharmaceutical agent 268. Existing between liquidpharmaceutical agent 268 and stopper 216 can be a gas bubble 270. Gasbubble 270 can be virtually any gas that can occupy the space requiredbetween the liquid pharmaceutical agent and the stopper. In someembodiments, a gas bubble is not included.

In some embodiments, the liquid pharmaceutical agent may be substitutedwith a semisolid or gel pharmaceutical agent. In some embodiments, apharmaceutical agent delivery vehicle can be used that can be extrudedfrom the needle.

In some embodiments, the gas can be an inert gas such as, but notlimited to argon, nitrogen, helium, and the like. In one embodiment, thegas bubble is nitrogen. In some embodiments, the devices describedherein do not include a gas bubble. In other embodiments, the gas bubbleis not needed as the end of a plunger stroke may not deplete the volumeof liquid in the syringe.

Pharmaceutical agents housed in syringe 212 can include any compoundhaving a therapeutic effect in a mammal that is experiencing a symptomof a drug or substance overdose. In some embodiments, the drug overdoseis from an illegal or recreational drug. In some embodiments, thesubstance overdose is from an illegal or recreational substance such as,but not limited to, alcohol, smoke, or the like.

Mammals can include humans, equines, canines, felines, bovines, and thelike. In one embodiment, an mammal can be a human.

Non-limiting pharmaceutical agents can include a narcotic blocker, anopioid blocker, or a combination thereof. In some embodiments, salts,prodrugs, derivatives and/or analogues of the herein describedpharmaceutical agents can be provided alone or in combination.

In some embodiments, pharmaceutical agent(s) included in the hereindescribed syringes can be used to treat a symptom of a drug or substanceoverdose or the overdose itself. The pharmaceutical agent(s) included inthe herein described syringes can be used to treat symptoms such asdifficulty breathing, shortness of breath, breathlessness, tightness ofthroat, slow heartbeat, no heartbeat, weak pulse, dizziness, passingout, blackout, unconsciousness, itching, swelling, itching in thethroat, swelling in the throat, vomiting, diarrhea, cramps, orcombinations thereof. In some embodiments, the pharmaceutical agent(s)included in the herein described syringes can be used to treatcombinations of the above symptoms in an overdose. In still otherembodiments, the pharmaceutical agent(s) included in the hereindescribed syringes can be used to treat other symptoms and/or conditionsin an emergency situation.

In one embodiment, the pharmaceutical agent is naloxone, salts thereof,derivatives thereof, and/or prodrugs thereof. In one embodiment,naloxone is provided as a HCL dihydrate.

Naloxone, salts thereof, derivatives thereof, and/or prodrugs thereofcan be present at a concentration of about 1 mg/mL, about 2 mg/mL, about3 mg/mL, about 4 mg/mL, about 5 mg/mL, about 6 mg/mL, about 7 mg/mL,about 8 mg/mL, about 9 mg/mL, about 10 mg/mL, about 11 mg/mL, about 12mg/mL, about 13 mg/mL, about 14 mg/mL, about 15 mg/mL, about 16 mg/mL,about 17 mg/mL, about 18 mg/mL, about 19 mg/mL, about 20 mg/mL, about 22mg/mL, about 24 mg/mL, about 26 mg/mL, about 28 mg/mL, about 30 mg/mL,about 40 mg/mL, about 50 mg/mL, about 60 mg/mL, about 70 mg/mL, about 80mg/mL, about 90 mg/mL, about 100 mg/mL, between about 5 mg/mL and about15 mg/mL, between about 10 mg/mL and about 20 mg/mL, between about 10mg/mL and about 100 mg/mL, between about 1 mg/mL and about 100 mg/mL,between about 50 mg/mL and about 100 mg/mL, at least about 4 mg/mL, atleast about 8 mg/mL, at least about 15 mg/mL, at least about 25 mg/mL,or at least about 50 mg/mL. In other embodiments, naloxone, saltsthereof, derivatives thereof, and/or prodrugs thereof can be included insyringes described herein to deliver about 1 mg, about 2 mg, about 3 mg,about 4 mg, about 5 mg, about 6 mg, about 7 mg, about 8 mg, about 9 mg,about 10 mg, about 11 mg, about 12 mg, about 13 mg, about 14 mg, about15 mg, about 16 mg, about 17 mg, about 18 mg, about 19 mg, about 20 mg,about 30 mg, about 40 mg, about 50 mg, about 60 mg, about 70 mg, about80 mg, about 90 mg, about 100 mg, between about 1 mg and about 20 mg,between about 5 mg and about 15 mg, between about 1 mg and about 100 mg,between about 1 mg and about 50 mg, between about 10 mg and about 100mg, between about 50 mg and about 100 mg, between about 25 mg and about50 mg, at least about 1 mg, at least about 5 mg, at least about 10 mg,at least about 15 mg, at least about 20 mg, or at least about 50 mg ofnaloxone in a single injectable dose even if more than that amount ispresent in the syringe prior to assembly of a syringe device.

In some embodiments, the concentration or dose of naloxone can beadministered using a single syringe devices. In other embodiments, theconcentration or dose of naloxone can be administered using two or moresyringe devices.

In one embodiment, a drug as described herein, salts thereof,derivatives thereof, and/or prodrugs thereof can be in a formulationwith a carrier. The formulation can include the drug(s), a salt thereof,derivatives thereof, or prodrugs thereof, one or more tonicityadjuster(s) such as e.g. sodium chloride or other salts, an acid or baseto adjust pH, such as e.g. hydrochloric acid or sodium hydroxide, and asolvent or carrier. In some embodiments, the formulation can be in anaqueous formulation and can also include an antioxidant. The antioxidantcan be Na-metabisulfite or any other appropriate antioxidant. In stillother embodiments, formulations can include an excipient(s) such as butnot limited to, a preservative(s), a sorbent(s), a lubricant(s), avehicle, or the like.

In one embodiment, naloxone, salts thereof, derivatives thereof, and/orprodrugs thereof can be in a formulation with a carrier. The formulationcan include naloxone, a salt thereof, derivatives thereof, or prodrugsthereof, one or more tonicity adjuster(s) such as e.g. sodium chlorideor other salts, an acid or base to adjust pH, such as e.g. hydrochloricacid or sodium hydroxide, and a solvent or carrier.

In some embodiments, the formulation can be in an aqueous formulationand can also include an antioxidant. The antioxidant can beNa-metabisulfite or any other appropriate antioxidant. In still otherembodiments, formulations can include an excipient(s) such as but notlimited to, a preservative(s), a sorbent(s), a lubricant(s), a vehicle,or the like.

In some embodiments, the carrier is aqueous. In one embodiment, thecarrier is water for injection.

The salt included in a formulation can be any salt. In one embodiment,the salt is sodium chloride, potassium chloride, calcium chloride,ammonium chloride, glycyrrhizic acid, mesitylene sulfonate sodium,chondroitin sulfate, potassium sulfate, monensin sodium salt, sodiumhyaluronate, glutamic acid sodium salt, sodium benzoate, magnesiumsulfate, or a combination thereof.

In some embodiments, a salt can be included in a formulation to providean appropriate tonicity.

The acid used to adjust the pH of the formulation can be any acid. Inone embodiment, the acid is hydrochloric acid.

In one embodiment, every 1 mL of a formulation can include 5 mg ofnaloxone.

In one embodiment, every 0.5 mL of a formulation can include 5 mg ofnaloxone.

In another embodiment, every 1 mL of a formulation can include 15 mg ofnaloxone.

In another embodiment, every 0.5 mL of a formulation can include 15 mgof naloxone.

In one embodiment, a drug formulation is provided that includesnaloxone, sodium chloride, water for injection, and hydrochloric acid asneeded to adjust pH. In another embodiment, a drug formulation isprovided that includes 2.2 g of naloxone, 1.67 g of sodium chloride, 200g of water for injection, and 1% hydrochloric acid as needed to adjustpH. In some embodiments, 1 g of naloxone HCl is equivalent to 1.11 g ofnaloxone HCL dihydrate and is adjusted for purity.

In some embodiments, the drugs can be filled into the syringes in aparticular or specific amount. That particular amount can be about 0.2cc, about 0.3 cc, about 0.4 cc, about 0.5 cc, about 0.6 cc, about 0.7cc, about 0.8 cc, about 0.9 cc, about 1 cc, about 2 cc, between about0.4 cc and about 0.6 cc, between about 0.1 cc and about 1 cc, betweenabout 0.3 cc and about 0.7 cc. In one embodiment, the filling volume canbe about 0.5 cc.

FIG. 4 illustrates a non-limiting assembly method for the syringedevices as described herein. As a first step 400, a syringe is filledwith a desired drug, and if desired, an appropriately sized gas bubble.In some embodiments, a bubble is not included and/or is not needed. Aplunger rod is then screwed to the syringe's stopper. In a second step402, a spacer is added around the plunger rod. In a next step 404, theactuator is attached opposite the spacer. A top is then placed on thespacer and actuator to complete the plunger assembly in a fourth step406. A spring and a syringe stop ring are then slid down around thesyringe body until they meet the syringe's flange in a fifth step 408.

Separately, in step 410 a needle guard is added to an empty encasementand retracted into the encasement. Appropriate label(s) are added to theencasement in step 410 as well.

Next, in step 412, the encasement is then slid over the syringe thatincludes the plunger assembly and snapped into place attached to thetop's teeth. Any additional labels can be added to complete the assemblyof the herein described syringe in step 414.

In some embodiments, the syringe devices are single use and/ordisposable. Such single use devices are generally used for a singletreatment and then discarded in an appropriate manner consistent withhealth regulations.

In some embodiments, the contents of syringe devices and devicesthemselves are sterile. Sterile syringe devices can be obtained bysterile filling and device assembly or by sterilizing the syringedevices after assembly. The syringe devices described herein can besterilized using conventional sterilization techniques such as, but notlimited to gamma irradiation techniques.

Syringe devices described herein can be packaged for distribution tousers. Packaging can take on forms that can at least partially encase orcover portions of the syringe devices that may be conducive tointerference. In one embodiment, syringe devices can be fully encased.

An example case for syringe device 100 is illustrated in FIGS. 5A-C, 6,and 7. Case 500 can be opened and closed on a hinge 502 and a lockingmechanism 504. Locking mechanism 504 can allow for a single use ormultiple uses. In one embodiment, locking mechanism 504 can be a hookand catch mechanism.

Case 500 can be shaped to fit a single syringe device. FIG. 5Cillustrates a syringe device 100 loaded in case 500. In one embodiment,case 500 can be configured to be at least as long as syringe device 100from the tip of a needle cover to the top of an actuator finger surfacein a ready to use configuration. In other embodiments, case 500 can beconfigured to hold syringe device 100 in an angled configuration.

Allowing syringe device 100 to sit at angle 506 can allow for case 500to have a wider bottom portion 508 than top portion 510. Because topportion 510 and bottom portion 508 are not the same, a non-linear edge512 is created. A second case 514 as illustrated in FIG. 7 can be spun180 degrees and the non-linear edge of each can be matched up.

Angle 506 shown in FIG. 5B can be about 3 degrees, about 4 degrees,about 5 degrees, about 6 degrees, about 7 degrees, about 8 degrees,about 9 degrees, about 10 degrees, between about 3 degrees and about 8degrees, between about 4 degrees and about 6 degrees, or at least about3 degrees. In one embodiment, angle 506 is about 5 degrees.

In some embodiments, each case can include a fastening nub 516 and areceiving orifice 518 can be included on non-linear edge 512. Receivingorifice 518 can have a key hole configuration allowing for fastening nub516 to be inserted into the larger portion of the key hole and slid andlocked into place. Thus, when case 500 and second case 514 are mated,two sets of fastening nubs and receiving orifices can be used to holdthe two cases together.

Fitting two cases together can allow a user to carry a single dose of adrug in case of an emergency and have a second dose close at hand incase a second dosage is needed. FIG. 7 illustrates two cases joinedtogether. Angling the syringe device within a case allows for theoverall length of the case to be reduced. The extra width of a case ismitigated by the ability to join two cases together with an overalljoined width that is less than double the width of a single case. Thus,this joined configuration can meet a need to have multiple dosages witha small physical footprint.

Case 500 (or second case 514) can include one or more labels thatprovide information about the drug or drugs being delivered via anenclosed syringe device. As illustrated in FIGS. 5A-C, 6, and 7, caselabel 520 can cover substantially an entire surface of case 500.However, in other embodiments, case label 520 may cover less than anentire surface of case 500 or multiple labels can be used instead of onelarge label. In fact, in some embodiments, any number of labels of anyshapes can be used to label a case as needed.

Cases can be formed of any appropriate material that can house thedescribed syringes through loading, shipping, regular carrying bypatients, and the like without damage to an enclosed syringe device. Insome embodiments, cases can be formed of a polymeric material such as athermoplastic. In one embodiment, cases can be formed of a polypropylenematerial. Cases can be extruded, blow molded, or the like.

Cases can be textured on portions of their surface in order to allow auser to easily grip a case(s). In one embodiment, cases can be texturedusing MT-11010.

Cases can have identification markers such as an arrow(s) indicatingwhich side of the case is used to open it. In some embodiments, raisedfeatures can be used so that a user when administering an injection to apatient in an emergency drug overdose can open the case without actuallyfocusing on it. Also, in some embodiments, by including a non-linearedge, tactile opening of the case can be accomplished knowing that thethicker end of the case is opened.

Further, cases can be color coded to indicate a particular drug. Casescan be color coded to indicate the order of use of the enclosed syringedevice.

An example use of a syringe device as described herein is illustrated inFIG. 8 . FIG. 8 is illustrated in the context of the non-limiting use ofnaloxone and illustrates an instruction insert 800. Insert 800 includesa diagram 802 of the syringe device itself, labeling the various useparts of the device for a clear illustration for a user during anemergency drug overdose situation (parts not labeled for simplicity).

As a first step 804, the user is instructed to remove a syringe devicefrom a container and examine the patient for an appropriate injectionsite. In one embodiment, the injection can be on the thigh. Althoughdescribed as using a thigh, other injection sites can be used, such asbut not limited to the arm, stomach, buttocks, abdomen, and the like. Insome embodiments, injections can be made into muscles.

As a second step 806, a user is instructed to remove the needle cap withthe syringe device pointing up.

As a third step 808, a user is shown how to properly hold the syringedevice for injection. The user is instructed to inject the patient andput the needle in until it is no longer visible. The plunger (actuator)is pushed until it stops and clicks. The audible click is an indicationto the user that the drug has been fully injected. The user isinstructed to leave the needle in the skin for an additional two secondsto allow proper absorption. Further, the user is told that excess liquidwill remain in the syringe device.

The user is instructed in a forth step 810 to remove the needle andslide the needle guard over the needle. The user then places thatsyringe device back in the case and snaps the case closed.

Optionally, the user is instructed to massage the location for about 10seconds. In other embodiments, longer or shorter massages may berequired, such as but not limited to, about 5 seconds, about 15 seconds,about 20 seconds, about 25 seconds, about 30 seconds, between about 5seconds and about 20 seconds, between about 10 seconds and about 20seconds, at least about 5 seconds, or at least about 10 seconds.

As a fifth step 812 the user is instructed to wait a given time periodto determine if the injection has been effective. This time period canbe at least about 10 seconds, at least about 20 seconds, at least about30 seconds, at least about 1 minute, or at least about 5 minutes.Effectiveness can manifest in events including a sensed heartbeat, astronger heartbeat, breathing, movement, or the like.

The user is instructed to seek medical help and/or to call an emergencyline (e.g., 911). The user is told to inform the medical help that theyjust administered an injection of naloxone. The user is furtherinstructed to give the used needle case including the used syringedevice to the medical workers when they arrive.

If the injection is ineffective, the user is told to use the secondsyringe device if needed as a sixth step 814.

The user is instructed that seeking medical help and/or to calling anemergency line (e.g., 911) can occur at any time during the process. Theuser need not wait until step five to seek emergency medical help.

In some embodiments, the syringe devices described herein can beprovided as systems or kits. These systems and kits can include asyringe device enclosed in a container with instructions for use.

In other embodiments, systems and kits can include two syringe deviceseach enclosed in a separate container each with instructions for use. Instill other embodiments, a system or kit can include two syringe devicefilled containers that are connected as described herein.

In one embodiment, systems and kits can include a syringe device filledwith a therapeutic amount of a drug enclosed in a container withinstructions for use. In other embodiments, systems and kits can includetwo syringe devices each filled with a therapeutic amount of a drug,each enclosed in a separate container, and each including instructionsfor use. In still other embodiments, a system or kit can include twosyringe devices filled with a therapeutic amount of a drug in containersthat are connected as described herein.

In one embodiment, systems and kits can include a syringe device filledwith a therapeutic amount of an opioid antagonist enclosed in acontainer with instructions for use. In other embodiments, systems andkits can include two syringe devices each filled with a therapeuticamount of opioid antagonist, each enclosed in a separate container, andeach including instructions for use. In still other embodiments, asystem or kit can include two syringe devices filled with a therapeuticamount of opioid antagonist in containers that are connected asdescribed herein.

In one embodiment, systems and kits can include a syringe device filledwith a therapeutic amount of naloxone enclosed in a container withinstructions for use. In other embodiments, systems and kits can includetwo syringe devices each filled with a therapeutic amount of naloxone,each enclosed in a separate container, and each including instructionsfor use. In still other embodiments, a system or kit can include twosyringe devices filled with a therapeutic amount of naloxone incontainers that are connected as described herein.

In some embodiments, a syringe device(s) can be distributed to a patientwithout a drug included within it. The syringe device(s) can be loadedinto cases. These syringe devices can be used as training devices toallow a potential user to understand how the syringe device works sothat in an emergency overdose situation, they will be ready to use anactual syringe device. In some embodiments, a training device may notinclude a needle so that a trainee can partake in all the steps exceptthe needle injection portion.

In some embodiments, the syringe devices described herein can prevent auser from unscrewing the plunger rod from the stopper. This preventionability of the presently described syringe devices can disallow a changein travel stroke and hence delivered drug volume of traditionalsyringes. Further, the syringe devices described herein can prevent auser moving the plunger rod and/or stopper thereby affecting thedelivery volume of a drug filled syringe device. Further still, thepresently described syringe devices can prevent a user from pulling outand/or back the stopper/plunger rod thereby altering the deliveredvolume and the purity of the drug.

As discussed, the presently described syringe devices can providetactical feedback to alert a user of a complete drug dose delivery.Typical syringes only allow a tactical feedback when the stopper and/orplunger reach an end stop.

The presently described syringe devices can also prevent a user frommodifying the plunger and/or stopper to alter the amount of preset drugdelivery. The present syringe devices can deliver a preset drug dosagewithout intervention by the user that can alter an amount of drugdelivered.

The presently described syringe devices can prevent suboptimal druginjections by preventing unexpected syringe delivery orientations.Syringes can generally provide optimal delivery of drugs when orientedin a particular angle for injection. The present syringe devices canprovide a surface that can press against the injection site andeffectively hold the syringe devices at a predetermined angle forinjection.

In some embodiments, the presently described syringe devices do notinclude electronics. In some embodiments, the presently describedsyringe devices do not include a battery or batteries. In someembodiments, the presently described syringe devices do not include acircuit board. In some embodiments, the presently described syringedevices do not include an energy source to move the actuator.

The following represent non-limiting embodiments.

Embodiment 1: An emergency syringe device comprising a syringe includinga therapeutic dose of at least one opioid antagonist, and a stopper; anda plunger assembly including a plunger rod, an actuator, and a spacer,wherein the plunger assembly is configured to move the stopper apredetermined distance without a user touching the plunger rod or beingable to retract the plunger rod.

Embodiment 2: The syringe device of Embodiment 1, wherein the plungerassembly is configured to provide substantially identical doses of theat least one opioid antagonist even if more or less opioid antagonist isprovided in the syringe by moving the stopper a predetermined distance.

Embodiment 3: The syringe device of Embodiment 1 or 2, further includingan encasement configured to house the syringe.

Embodiment 4: The syringe device of Embodiment 1, 2, or 3, wherein theencasement includes a window configured to allow the user to view the atleast one opioid antagonist in the syringe.

Embodiment 5: The syringe device of Embodiment 1, 2, or 3, wherein theencasement includes a needle guard configured to allow the user to coverthe needle after use.

Embodiment 6: The syringe device of Embodiment 1, 2, 3, 4, or 5, whereinthe at least one opioid antagonist is naloxone, a salt thereof, aderivative thereof, or a prodrug thereof.

Embodiment 7: The syringe device of Embodiment 1, 2, 3, 4, 5, or 6,wherein the at least one opioid antagonist is naloxone.

Embodiment 8: The syringe device of Embodiment 1, 2, 3, 4, 5, 6, or 7,wherein the syringe device is configured to deliver about 5 mg ofnaloxone or a salt thereof.

Embodiment 9: The syringe device of Embodiment 1, 2, 3, 4, 5, 6, or 7,wherein the syringe device is configured to deliver about 15 mg ofnaloxone or a salt thereof.

Embodiment 10: The syringe device of Embodiment 1, 2, 3, 4, 5, 6, 7, 8,or 9, wherein the actuator and the spacer are configured to be securedaround the plunger rod.

Embodiment 11: The syringe device of Embodiment 1, 2, 3, 4, 5, 6, 7, 8,9, or 10, wherein the actuator includes a finger depression location.

Embodiment 12: The syringe device of Embodiment 1, 2, 3, 4, 5, 6, 7, 8,9, 10, or 11 configured for use in an opioid overdose.

Embodiment 13: A method for administering a therapeutic dose of at leastone opioid antagonist, the method comprising advancing a stopper througha syringe including the therapeutic dose of the at least one opioidantagonist; wherein the stopper is only advanced a predetermineddistance by a plunger assembly including a plunger rod, an actuator, anda spacer, wherein the plunger assembly is configured to move the stopperwithout a user touching the plunger rod.

Embodiment 14: The method of Embodiment 13, wherein the syringe ishoused in an encasement.

Embodiment 15: The method of Embodiment 13 or 14, wherein the encasementincludes a window configured to allow the user to view the at least oneopioid antagonist in the syringe.

Embodiment 16: The method of Embodiment 13 or 14, wherein the encasementincludes a needle guard configured to allow the user to cover a needleafter use.

Embodiment 17: The method of Embodiment 13, 14, 15, or 16, wherein theat least one opioid antagonist is naloxone, a salt thereof, a derivativethereof, or a prodrug thereof.

Embodiment 18: The method of Embodiment 13, 14, 15, 16, or 17, whereinthe at least one opioid antagonist is naloxone.

Embodiment 19: The method of Embodiment 13, 14, 15, 16, 17, or 18,wherein the actuator and the spacer are configured to be secured aroundthe plunger rod and provide the predetermined distance.

Embodiment 20: The method of Embodiment 13, 14, 15, 16, 17, 18, or 19,wherein the actuator and the spacer are configured to provide thepredetermined distance between a start point and an end point.

Embodiment 21: The method of Embodiment 13, 14, 15, 16, 17, 18, 19, or20, wherein the advancing the stopper the predetermined distance isconfigured to deliver about 5 mg of naloxone or a salt thereof.

Embodiment 22: The method of Embodiment 13, 14, 15, 16, 17, 18, 19, 20,or 21, wherein the advancing the stopper the predetermined distance isconfigured to deliver about 15 mg of naloxone or a salt thereof.

Example 1 Emergency Naloxone Administration

A 45 year old female suffers from frequent heroin use. After injecting alarge dose of heroin intravenously at a party, the female begins to showsymptoms of overdose and becomes unconscious. Her heart rate slows andher breath becomes shallow. An onlooker at the party calls 911. Theonlooker finds a kit of two naloxone filled syringe devices housed inseparate connected cases stocked in the locations first aid kit. Heopens one case and removes the syringe device.

An injection area is determined on the female's thigh. He removes theneedle cap, inserts the needle into the female's thigh in the selectedarea, and pushes the plunger until he hears a click. He leaves theneedle in the female's thigh for an additional two seconds. He thenremoves the needle from the female's thigh, slides down the needle cap,places the syringe device back in the container, and shuts thecontainer.

The female slowly regains consciousness. Medical emergency personnelarrive shortly thereafter and transport the female to a local emergencyroom for further treatment.

Example 2 Emergency Naloxone Aided Injection

A 65 year old man is depressed and ingests a bottle of prescriptionopioids, thus overdosing himself. The man's wife finds the man barelyconscious. The wife calls 911 while she pulls out a kit of two naloxonefilled syringe devices housed in separate connected cases. She pops openone case and removes the syringe device.

She selects an injection area on the man's thigh. She removes the needlecap, inserts the needle into the man's thigh in the selected area, andpushes the plunger until she hears a click. She then removes the needlefrom the man's thigh, slides down the needle cap, places the syringedevice back in the container, and shuts the container.

She notices that the injection has little effect on the man. Thus, shepops open the second case and removes the syringe device inside. Sherepeats injection with the second device. She again removes the needlefrom the man's thigh, slides down the needle cap, places the syringedevice back in the container, and shuts the container.

The man slowly regains consciousness. Medical emergency personnel arriveshortly thereafter and transport the man to a local emergency room forfurther treatment.

Example 3

In Example 1 and Example 2, each syringe in the kit includes 5 mg ofnaloxone.

Example 4

In Example 1 and Example 2, each syringe in the kit includes 2.5 mg ofnaloxone.

Example 5

In Example 1 and Example 2, each syringe in the kit includes 10 mg ofnaloxone.

Example 6

In Example 1 and Example 2, each syringe in the kit includes 15 mg ofnaloxone.

Unless otherwise indicated, all numbers expressing quantities ofingredients, properties such as molecular weight, reaction conditions,and so forth used in the specification and claims are to be understoodas being modified in all instances by the term “about.” Accordingly,unless indicated to the contrary, the numerical parameters set forth inthe specification and attached claims are approximations that may varydepending upon the desired properties sought to be obtained by thepresent invention. At the very least, and not as an attempt to limit theapplication of the doctrine of equivalents to the scope of the claims,each numerical parameter should at least be construed in light of thenumber of reported significant digits and by applying ordinary roundingtechniques. Notwithstanding that the numerical ranges and parameterssetting forth the broad scope of the invention are approximations, thenumerical values set forth in the specific examples are reported asprecisely as possible. Any numerical value, however, inherently containscertain errors necessarily resulting from the standard deviation foundin their respective testing measurements.

The terms “a,” “an,” “the” and similar referents used in the context ofdescribing the invention (especially in the context of the followingclaims) are to be construed to cover both the singular and the plural,unless otherwise indicated herein or clearly contradicted by context.Recitation of ranges of values herein is merely intended to serve as ashorthand method of referring individually to each separate valuefalling within the range. Unless otherwise indicated herein, eachindividual value is incorporated into the specification as if it wereindividually recited herein. All methods described herein can beperformed in any suitable order unless otherwise indicated herein orotherwise clearly contradicted by context. The use of any and allexamples, or exemplary language (e.g., “such as”) provided herein isintended merely to better illuminate the invention and does not pose alimitation on the scope of the invention otherwise claimed. No languagein the specification should be construed as indicating any non-claimedelement essential to the practice of the invention.

Groupings of alternative elements or embodiments of the inventiondisclosed herein are not to be construed as limitations. Each groupmember may be referred to and claimed individually or in any combinationwith other members of the group or other elements found herein. It isanticipated that one or more members of a group may be included in, ordeleted from, a group for reasons of convenience and/or patentability.When any such inclusion or deletion occurs, the specification is deemedto contain the group as modified thus fulfilling the written descriptionof all Markush groups used in the appended claims.

Certain embodiments of this invention are described herein, includingthe best mode known to the inventors for carrying out the invention. Ofcourse, variations on these described embodiments will become apparentto those of ordinary skill in the art upon reading the foregoingdescription. The inventor expects skilled artisans to employ suchvariations as appropriate, and the inventors intend for the invention tobe practiced otherwise than specifically described herein. Accordingly,this invention includes all modifications and equivalents of the subjectmatter recited in the claims appended hereto as permitted by applicablelaw. Moreover, any combination of the above-described elements in allpossible variations thereof is encompassed by the invention unlessotherwise indicated herein or otherwise clearly contradicted by context.

In closing, it is to be understood that the embodiments of the inventiondisclosed herein are illustrative of the principles of the presentinvention. Other modifications that may be employed are within the scopeof the invention. Thus, by way of example, but not of limitation,alternative configurations of the present invention may be utilized inaccordance with the teachings herein. Accordingly, the present inventionis not limited to that precisely as shown and described.

We claim:
 1. An emergency syringe device comprising: a syringe includinga therapeutic dose of at least one opioid antagonist, and a stopper; anda plunger assembly including a plunger rod, an actuator, and a spacer,wherein the plunger assembly is configured to move the stopper apredetermined distance without a user touching the plunger rod or beingable to retract the plunger rod.
 2. The syringe device of claim 1,wherein the plunger assembly is configured to provide substantiallyidentical doses of the at least one opioid antagonist even if more orless opioid antagonist is provided in the syringe by moving the stoppera predetermined distance.
 3. The syringe device of claim 1, furtherincluding: an encasement configured to house the syringe.
 4. The syringedevice of claim 3, wherein the encasement includes a window configuredto allow the user to view the at least one opioid antagonist in thesyringe.
 5. The syringe device of claim 3, wherein the encasementincludes a needle guard configured to allow the user to cover a needleassociated with the syringe after use.
 6. The syringe device of claim 1,wherein the at least one opioid antagonist is naloxone, a salt thereof,a derivative thereof, or a prodrug thereof.
 7. The syringe device ofclaim 1, wherein the at least one opioid antagonist is naloxone.
 8. Thesyringe device of claim 6, wherein the syringe device is configured todeliver about 5 mg of naloxone or a salt thereof.
 9. The syringe deviceof claim 6, wherein the syringe device is configured to deliver about 15mg of naloxone or a salt thereof.
 10. The syringe device of claim 1,wherein the actuator and the spacer are configured to be secured aroundthe plunger rod.
 11. The syringe device of claim 1, wherein the actuatorincludes a finger depression location.
 12. The syringe device of claim 1configured for use in an opioid overdose.
 13. A method for administeringa therapeutic dose of at least one opioid antagonist, the methodcomprising: providing an emergency syringe device; advancing a stopperon the syringe device through a syringe including the therapeutic doseof the at least one opioid antagonist; wherein the stopper is onlyadvanced a predetermined distance by a plunger assembly including aplunger rod, an actuator, and a spacer, wherein the plunger assembly isconfigured to move the stopper without a user touching the plunger rod.14. The method of claim 13, wherein the syringe is housed in anencasement.
 15. The method of claim 14, wherein the encasement includesa window configured to allow the user to view the at least one opioidantagonist in the syringe.
 16. The method of claim 14, wherein theencasement includes a needle guard configured to allow the user to covera needle after use.
 17. The method of claim 13, wherein the at least oneopioid antagonist is naloxone, a salt thereof, a derivative thereof, ora prodrug thereof.
 18. The method of claim 17, wherein the at least oneopioid antagonist is naloxone.
 19. The method of claim 13, wherein theactuator and the spacer are configured to be secured around the plungerrod and provide the predetermined distance.
 20. The method of claim 13,wherein the actuator and the spacer are configured to provide thepredetermined distance between a start point and an end point.
 21. Themethod of claim 13, wherein the advancing of the stopper thepredetermined distance is configured to deliver about 5 mg of naloxoneor a salt thereof.
 22. The method of claim 13, wherein the advancing ofthe stopper the predetermined distance is configured to deliver about100 mg of naloxone or a salt thereof.